Provider Demographics
NPI:1053456806
Name:RAMIREZ, IVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:IVAN
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1867 E FIR AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3808
Mailing Address - Country:US
Mailing Address - Phone:559-325-5800
Mailing Address - Fax:559-325-5838
Practice Address - Street 1:1867 E FIR AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3808
Practice Address - Country:US
Practice Address - Phone:559-325-5800
Practice Address - Fax:559-325-5838
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2008-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01063009A2085R0202X
CAA1027482085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology